Postpartum Depression Affects 1 In 7 Mothers

A JAMA Psychiatry study found that 1 in 7 mothers are affected by postpartum depression.

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Originally published on March 14, 2013 1:09 pm

It's well documented that some women suffer depression after having a baby. But it's less well-known just how many do.

The largest study to date shows that as many as 1 in every 7 women suffers postpartum depression. And the study, published in the journal JAMA Psychiatry, finds that among women followed for a year after delivery, some 22 percent had been depressed.

The study also recommends that all pregnant women and new mothers be screened for depression.

Ten-thousand women who delivered infants at one obstetrical hospital in Pittsburgh were asked to take part in a short telephone interview four to six weeks after they had their babies.

"We asked them whether they had been able to laugh and see the funny side of things," says University of Pittsburgh psychiatrist Dorothy Sit, who was one of the study investigators. Sit says researchers also asked about the new mothers' "ability to look forward with enjoyment to things, whether or not they're blaming themselves necessarily when things go wrong, feeling anxious or worried for no good reason, being scared or panicky for no good reason."

It turned out that 14 percent of the women were at an increased risk of postpartum depression, which is consistent with what other studies have found. But in Sit's study, home visits for further evaluation revealed that in many cases, the symptoms were very serious.

"We discovered 20 percent had suicidal thoughts — these are thoughts of death, thoughts of wanting to die, not wanting to wake up, just escape," Sit says. "In fact, some patients with very severe symptoms had made the decision to take their lives."

Sit says that screening all pregnant women and new mothers could help diagnose the problem and get treatment under way sooner.

It's unknown exactly why certain women are more vulnerable to postpartum depression. Genetics likely play a role. So do hormonal fluctuations during pregnancy, as well as the sleep deprivation that typically occurs in caring for a newborn.

At the Cleveland Clinic, Rebecca Starck directs the obstetrics unit where patients are routinely screened for depression during their third trimester of pregnancy and again after the birth of their child.

"Once they have the baby, before they leave the hospital, I often say, 'It's normal to have ups and downs and crying out of the blue," Starck says. "But if you feel like you can't sleep ... or if you feel like you're in a deep dark hole and you don't see a light at the end of the tunnel, you may, in fact, be somebody who needs to go on medication or have some counseling."

She adds that screening is critical because, once diagnosed, treatments are highly effective. She says that individual or group therapy and even medications like antidepressants can help the vast majority of women within a few months or a year.

But because many women are too embarrassed or guilt-ridden to admit they feel bad, they don't get diagnosed or treated. Starck says she often tells her patients and their families that "this is out of your control."

Both doctors say that universal screening for depression could help women sift through their feelings and identify those at risk for depression. But the American College of Obstetrics and Gynecology says more evidence is needed before that recommendation can be made.

Even so, the college suggests doctors or health care workers perform a thorough psychiatric evaluation for any woman who has a history of depression.

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AUDIE CORNISH, HOST:

It's well-documented that some women suffer depression after having a baby. But how many women is not as well-known, and it's difficult to predict who they might be. Now, a large, new study in the journal JAMA Psychiatry shows that as many as 1 in every 7 women suffers postpartum depression.

As NPR's Patti Neighmond reports, that's leading some researchers to recommend depression screenings for all pregnant women and new mothers.

PATTI NEIGHMOND, BYLINE: Ten thousand women who delivered infants at a single obstetrical hospital were asked if they would take part in a short telephone interview four to six weeks after they delivered their baby. University of Pittsburgh psychiatrist Dorothy Sit was one of the study investigators.

DR. DOROTHY SIT: We asked them whether they have been able to laugh and see the funny side of things. Secondly, we are exploring about their ability to look forward, with enjoyment, to things; whether or not they're blaming themselves unnecessarily when things go wrong; feeling anxious or worried for no good reason; being scared or panicky for no good reason.

NEIGHMOND: It turned out 14 percent of the women were at increased risk of postpartum depression. A home visit for further evaluation followed and in many cases, the symptoms were very serious.

SIT: We discovered 20 percent had suicidal thoughts. These are thoughts of death; thoughts of wanting to die, not wanting to wake up, just escape. In fact, some patients with very severe symptoms made the decision to take their life.

NEIGHMOND: Sit says screening all pregnant women and new mothers could help diagnose the problem, and get treatment under way sooner. It's not known exactly why certain women are more vulnerable to postpartum depression. Genetics likely play a role; so do hormonal fluctuations during pregnancy as well as sleep deprivation that typically occurs in caring for a newborn. At the Cleveland Clinic, Dr. Rebecca Starck directs the obstetrics unit, where patients are routinely screened for depression during their third trimester of pregnancy, and then again after the birth of their child.

DR. REBECCA STARCK: Once they have the baby, before they leave the hospital, I say - you know - it's normal to have ups and downs, and crying out of the blue; and you don't expect it, and it just hits you. But if you feel like you can't sleep when you have the opportunity to sleep, or if you feel like you're in a deep, dark hole and you don't see a light at the end of the tunnel, you may, in fact, be somebody who needs to go on medication or have some counseling.

NEIGHMOND: Screening is critical, Starck says, because once diagnosed, treatments are highly effective. She says that individual or group therapy, even medications like antidepressants, can help the vast majority of women within a few months or a year. But because many women are too embarrassed or guilt-ridden to admit they feel bad, they don't get diagnosed or treated.

STARCK: Many women look at their current state and say, wow, I've got this new baby. This should be the best time in my life. And they feel overwhelming guilt, which makes the problem even worse. And then their family members don't necessarily understand. And what I often will tell my patients and their support - hopefully, they have family members with them - to say, you know, this is out of your control. This is out of her control.

NEIGHMOND: Both doctors say universal screening for depression could help women sift through their feelings, and identify those at risk for depression. But the American College of Obstetrics and Gynecology says more evidence is needed before that recommendation can be made. Even so, the college suggests that doctors or health care workers perform a thorough psychiatric evaluation for any woman who has a history of depression. Patti Neighmond, NPR News. Transcript provided by NPR, Copyright NPR.